Zijn benzo's kankerverwekkend?
Er bestaan veel aanwijzingen dat het gebruik van slaap en kalmeringmiddelen een verhoogd risico op kanker veroorzaken. Vier studies op een rijtje. Ik kopier hieronder de abstracts en geef voorafgaand kort mijn mening en interpretatie van het onderzoek.
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Studie 1: Samenvatting van standaard assays en dierproeven: 76.5% van alle 39 geteste benzo’s was gentoxisch (beschadigd DNA) of kankerverwekkend in de standaard assay op levende cellen. In muizen was 11% kankerverwekkend en bijna 28% gentoxisch. Spooky…
Genotoxicity and carcinogenicity studies of benzodiazepines.
This survey is a compendium of genotoxicity and carcinogenicity information of benzodiazepines and benzodiazepine analogues. Data from 51 drugs were collected; 41 of them are still in the market. Of the 51 drugs, 12 (23.5%) do not have retrievable genotoxicity or carcinogenicity data. The remaining 39 (76.5%) have at least one genotoxicity or carcinogenicity test result. Of these 39, 12 (30.8%) have at least one positive finding: 9 tested positive in at least one genotoxicity assay, 8 in at least one carcinogenicity assay, and 5 gave a positive result in both at least one genotoxicity assay and at least one carcinogenicity assay. In terms of correlation between results of the various genotoxicity assays and absence of carcinogenic activity in mice and/or rats or in other species, none of the 11 non-carcinogenic drugs tested positive in one of the various genotoxicity assay systems. Concerning the predictivity of genetic toxicology findings for the result(s) of long-term carcinogenesis assays, 18 drugs had both genotoxicity and carcinogenicity data; of these 11 (61.1%) were neither genotoxic nor carcinogenic, 2 (11.1%) were carcinogenic in at least one sex of mice or rats but tested negative in genotoxicity assays, and 5 (27.8%) gave a positive response in at least one genotoxicity assay and in at least one carcinogenicity assay. Only 8 (19.5%) of the 41 marketed benzodiazepines and benzodiazepine analogues had all data required by current guidelines for testing of pharmaceuticals.
http://www.ncbi.nlm....pubmed/17920927
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Studie 2: Epidemiologische studie in de VS uitgevoerd. Schokkend is dat er 3.6 keer toename is waargenomen in kanker de groep mensen die tussen de 1 en 18 slaap pillen per jaar consumeerde. Dat is praktisch iedereen hier op het forum.
Hypnotics' association with mortality or cancer: a matched cohort study
Objectives
An estimated 6%–10% of US adults took a hypnotic drug for poor sleep in 2010. This study extends previous reports associating hypnotics with excess mortality.
Setting
A large integrated health system in the USA.
Design
Longitudinal electronic medical records were extracted for a one-to-two matched cohort survival analysis.
Subjects
Subjects (mean age 54 years) were 10 529 patients who received hypnotic prescriptions and 23 676 matched controls with no hypnotic prescriptions, followed for an average of 2.5 years between January 2002 and January 2007.
Main outcome measures
Data were adjusted for age, gender, smoking, body mass index, ethnicity, marital status, alcohol use and prior cancer. Hazard ratios (HRs) for death were computed from Cox proportional hazards models controlled for risk factors and using up to 116 strata, which exactly matched cases and controls by 12 classes of comorbidity.
Results
As predicted, patients prescribed any hypnotic had substantially elevated hazards of dying compared to those prescribed no hypnotics. For groups prescribed 0.4–18, 18–132 and >132 doses/year, HRs (95% CIs) were 3.60 (2.92 to 4.44), 4.43 (3.67 to 5.36) and 5.32 (4.50 to 6.30), respectively, demonstrating a dose–response association. HRs were elevated in separate analyses for several common hypnotics, including zolpidem, temazepam, eszopiclone, zaleplon, other benzodiazepines, barbiturates and sedative antihistamines. Hypnotic use in the upper third was associated with a significant elevation of incident cancer; HR=1.35 (95% CI 1.18 to 1.55). Results were robust within groups suffering each comorbidity, indicating that the death and cancer hazards associated with hypnotic drugs were not attributable to pre-existing disease.
Conclusions
Receiving hypnotic prescriptions was associated with greater than threefold increased hazards of death even when prescribed <18 pills/year. This association held in separate analyses for several commonly used hypnotics and for newer shorter-acting drugs. Control of selective prescription of hypnotics for patients in poor health did not explain the observed excess mortality.
http://www.ncbi.nlm....les/PMC3293137/
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Studie 3: Epidemiologische studie: 19% toename in risico op kanker in mensen in Taiwan die benzo’s gebruikten.
Benzodiazepine use possibly increases cancer risk: a population-based retrospective cohort study in Taiwan.
OBJECTIVE:
To evaluate the possible association between benzodiazepine use and subsequent cancer risk in Taiwan.
METHOD:
In this population-based retrospective cohort study, we used data from 1996 to 2000 from the Taiwanese National Health Insurance system to investigate the possible association between benzodiazepine use and cancer risk. The exposure cohort (mean age = 47.9 years, standard deviation [SD] = 17.3 years) consisted of 59,647 patients with benzodiazepine use. Each patient from the exposure cohort was randomly frequency-matched by age and sex to a person from the cohort with no benzodiazepine exposure (the comparison group; mean age = 46.4 years, SD = 17.8 years). Each study subject was followed until a diagnosis of cancer was made (according to ICD-9-CM) or until the time the subject was censored for loss to follow-up, death, or termination of insurance-or to the end of 2009. A Cox proportional hazard regression analysis was conducted to estimate the effects of benzodiazepine use on cancer risk.
RESULTS:
In the group with benzodiazepine use, the overall risk of developing cancer was 19% higher than in the group without benzodiazepine exposure, and the difference between the groups was statistically significant (hazard ratio HR = 1.19; 99.6% CI, 1.08-1.32). With regard to individual types of cancer, the risk of developing liver cancer (HR 1.45; 99.6% CI, 1.10-1.90), prostate cancer (HR = 1.72; 99.6% CI, 1.10-2.70), and bladder and kidney cancer (HR = 1.76; 99.6% CI, 1.16-2.67) was significantly higher for the benzodiazepine cohort.
CONCLUSIONS:
This population-based study has shed light on a possible relationship between benzodiazepine use and increased cancer risk. Further large, thorough investigations are needed to confirm these findings.
http://www.psychiatr...4/v73n0429.aspx
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Studie 4: Klopt natuurlijk niks van de bovenstaande studies Aldus Pfizer en Nycomed (competing interests). De truc is de statistiek, als je maar voor de juiste factoren corrigeert dan verdwijnt de algehele correlatie is de boodschap.
En een overall toename in het risico op kanker is er niet, behalve dan maagkanker (40% risico toename) slokdarmkanker (43% risico toename2.80), leverkanker (81% toename), Longkanker (38% toename), pancreas kanker (38% toename) en nierkanker (91 % risico toename) (zie results). Dus, indien je geen maag, longen, slokdarm, lever, pancreas en nieren hebt, dan is het risico nihil. We zijn weer gerust. Thanks Pfizer!
Use of benzodiazepines or benzodiazepine related drugs and the risk of cancer: a population-based case-control study.
AIM:
Studies of the carcinogenic potential of benzodiazepines and related drugs (BZRD) have been equivocal. A recent study reported a 35% excess cancer risk among users of hypnotics, including benzodiazepines.
METHOD:
Using Danish nationwide registers, we conducted a matched case-control study of the association between BZRD and cancer risk. During 1 January 2002 and 31 December 2009, we identified 152 510 cases with a first time cancer who were matched (1:8) by age and gender to 1,220,317 cancer-free controls. A new-user design was applied by excluding all subjects who had used anxiolytics, hypnotics or sedatives during the first 2 years of available prescription data (1995-6). Odds ratios (ORs) with 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for potential confounders. In the primary analysis, long term use of BZRD was defined by a cumulative amount of ≥500 defined daily doses of BZRD within a period of 1 to 5 years prior to the index date.
RESULTS:
The adjusted OR for cancer associated with BZRD use was 1.09 (95% CI 1.04, 1.14). ORs were close to unity for most cancer sites, except stomach 1.40 (95% CI 1.05, 1.88), oesophagus 1.43 (95% CI 1.01, 2.02), liver 1.81 (95% CI 1.18, 2.80), lung 1.38 (95% CI 1.23, 1.54), pancreas 1.35 (95% CI 1.02, 1.79) and kidney 1.39 (95% CI 1.01, 1.91). For tobacco-related cancers, the OR was 1.15 (95% CI 1.09, 1.22) and for the remaining cancer sites 1.01 (95% CI 0.94, 1.08). Sub-group analyses revealed only small differences between different levels of exposure or different patient subgroups.
CONCLUSION:
BZRD use was not associated with an overall increase in cancer risk, except for what is likely explained by minor lifestyle confounding, e.g. smoking.
COMPETING INTERESTS
All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare MA and JH have participated in research projects funded by Nycomed, the manufacturer of nitrazepam, and Pfizer, the manufacturer of Halcion (triazolam) and Tafil (alprazolam), with grants paid to institutions where they have been employed. JH has personally received fees for teaching from Nycomed. AP and SF declare no conflicts of interest.
http://www.ncbi.nlm....pubmed/23043261
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Conclusie. Deze 4 papers zijn verre van allesomvattend. In total zijn er voor zover ik kon nagaan 15 epidemiologische studies die een positief verband vinden. Omdat er geen relatie is met de chemische structuur en het risico op kanker, en zelfs het gebruik van sederende antihistamines een positief verband had is de waarschijnlijke oorzaak de onderdrukking van het immuunsysteem waardoor virussen meer schade aanrichten en net ontstane kankercellen niet tijdig opgeruimd worden.
